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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

In response to strong lobbying activity and numerous comments from physicians, the Final Rule on Meaningful Use (Stage 1) included a provision for physicians to exclude certain measures that are outside the scope of their practice. This was primarily an accommodation made to enable specialists to participate in the EHR incentives program without substantially changing their practices—although some primary care physicians may find exclusions applicable to them as well.

For a physician to exclude a measure:

The measure must be explicitly identified as “excludable” in the Final Rule—not all measures contain such a provision. (6 core and 7 menu measures are potentially excludable, but for some there will be very few providers who would meet the criteria.)

The physician must meet the defined criteria for exclusion of that particular measure.

The physician must attest that he/she meets these criteria.

Excluding a measure is the equivalent of meeting that measure. Therefore, if a physician excludes one (or more) of the menu measures, he/she only has to satisfy 4 of the remaining 9 menu measures (or 3 of the 8, etc.) The excluded measure does not have to be replaced by another measure.

In the next Meaningful Use Monday posts, I will address each of the measures individually and will identify the eligibility criteria where exclusions exist. I’ll start with Reporting on Clinical Quality Measures (one of the 15 Core meaningful use measures) because while not technically excludable, there is an accommodation available for the many specialists who find none of the measures relevant.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

John requested that the next series of Meaningful Use Monday posts explore the ins and outs of the individual meaningful use measures. To begin this process, today’s post reviews the basic requirements and the type of information that providers will report. Next Monday’s post will address the options available to some providers to exclude certain measures. Following that, I will address the measures, one by one, week by week (…although I can’t promise that I won’t digress as subjects of timely interest arise!)

By now, most people interested in meaningful use know that there are 25 measures and that they are divided into two sets—Core and Menu. Providers must meet all 15 of the core measures and any 5 of the 10 menu set measures, as long as one public health measure is included. (Another way to look at the menu set is that providers can defer—presumably to Stage 2—5 of the 10 menu measures.)

How each of the 25 measures is reported varies in a number of ways, so it is important to carefully read the requirements:

For some measures, providers will be asked to simply attest that “Yes”, they met the measure—e.g., implemented a particular EHR functionality or performed a test of a specific capability.

Other measures have thresholds that must be met, and therefore require the reporting of numerators and denominators, using data generated by the EHR.

Denominators vary, e.g., some are based on all patients seen, while others refer to a particular subset of patients.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Registration and attestation are detailed processes which will demand a significant amount of physicians’ time. During a CMS/ONC session at HIMSS, an audience member asked whether each of her organization’s 800 physicians had to personally go onto the CMS portal and register individually. In response to the answer “yes”, she suggested that CMS should at least allow physicians to assign a “proxy” to an administrative staff member to complete the registration process on their behalf.

I am happy to report that such a process is in the planning stages for both registration and attestation, (at least for participants in the Medicare program), according to a recently posted FAQ on the CMS website—but physicians will have to wait until at least May to take advantage of it. Physicians must still register and attest individually, (as opposed to by group), but they will be able to designate a third party to handle these administrative tasks for them. Until this system is in place, however, each eligible professional will have to register for himself or herself. So, unless a physician is planning to attest to meaningful use early this year, it might pay to wait a few months to register.

Lynn Scheps is Vice President, Government Affairs at EMR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out the previous Meaningful Use Monday posts.

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